Location and orientation estimation of devices incorporating permanent magnets

ABSTRACT

Methods, systems and devices for estimating the position and orientation of an invasive surgical devices, for example, a catheter guidewire or endoscope, surgical catheter, or self-guided electrophysiology catheter, relative to a reference frame, are described. An example system comprises one or more permanent magnets mounted on the surgical device, a plurality of magnetometer sensors at fixed location providing a reference frame that are configured to perform magnetic field measurements of the direct current superposition field of the permanent magnets, and computational means for receiving the input signals and calculating the position and orientation of the permanent magnets mounted on the surgical device.

CROSS-REFERENCE TO RELATED APPLICATION

This patent document is a divisional of U.S. Non-Provisional patentapplication Ser. No. 17/345,837, filed on Jun. 11, 2021, which claimspriority to and benefits of U.S. Provisional Patent Application No.63/038,544, filed on 12 Jun. 2020. The entire content of these patentapplications are incorporated by reference as part of the disclosure ofthis patent document.

TECHNICAL FIELD

This document generally relates to localization, and more particularlyto estimating the location and orientation of devices incorporatingpermanent magnets.

BACKGROUND

During both diagnostic and therapeutic procedures, it is often necessaryor desirable to determine the location of a medical probe. For example,a catheter or catheter guidewire must typically be navigated through apatient's body in order to locate the operative portion of the catheteradjacent to a target tissue region. Traditionally, this has beenaccomplished using fluoroscopy, a time series of X-ray bursts each ofwhich can provide partial position information at a snapshot in time ofthe surgical device and the body. However, there are significantlimitations and undesired properties of fluoroscopy.

SUMMARY

Embodiments of the disclosed technology relates to methods, systems anddevices for estimating the location and orientation of devicesincorporating permanent magnets. The methods and devices described inthe present document advantageously, among other features and benefits,allow the physician and medical team unrestricted access to the patientwith no physical blockages due to the localization system, and provideaccurate position and orientation information at a consistently highdata rate for real-time visualization.

In an example aspect, a system for estimating a location or anorientation of an invasive medical device includes one or more permanentmagnets incorporated into the invasive medical device, a plurality ofmagnetic field sensors arranged in a specific topology separate from theinvasive medical device, the plurality of magnetic field sensorsconfigured to obtain a plurality of magnetic field measurements of theone or more permanent magnets of the invasive medical device, and one ormore processors, coupled to the plurality of magnetic field sensors,configured to receive the plurality of magnetic field measurements, andenable a calculation of the location or the orientation of the one ormore permanent magnets based on the plurality of magnetic fieldmeasurements.

In another example aspect, a method for obtaining a location or anorientation of an invasive medical device inside a patient includesreceiving, from a plurality of magnetic field sensors arranged in aspecific topology separate from the invasive medical device, a firstplurality of magnetic field measurements associated with one or morepermanent magnets incorporated into the invasive medical device that isat a first position within the patient, determining the location or theorientation of the invasive medical device at the first position basedon the first plurality of magnetic field measurements, receiving, fromthe plurality of magnetic field sensors, a second plurality of magneticfield measurements associated with the one or more permanent magnets,wherein the invasive medical device is at a second position within thepatient, and updating the location or the orientation of the invasivemedical device by determining the location or the orientation of theinvasive medical device at the second position based on the secondplurality of magnetic field measurements.

In yet another example aspect, the above-described methods may beimplemented by an apparatus or device that comprises a processor and/ormemory.

In yet another example aspect, these methods may be embodied in the formof processor-executable instructions and stored on a computer-readableprogram medium.

The subject matter described in this patent document can be implementedin specific ways that provide one or more of the following features.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates an example of a catheter with a permanent magnet nearthe distal tip with an active electrophysiology (EP) end-cap.

FIG. 2 illustrates an example of a catheter with two permanent magnets,and with an active EP end-cap.

FIG. 3 illustrates an example of a catheter guidewire with a cylindricalmagnet surrounding one or more central lumens.

FIG. 4A illustrates an example of a catheter guidewire with twocylindrical magnets, surrounding one or more central lumens, separatedby a flexible wire section.

FIG. 4B illustrates another example of a catheter guidewire with twocylindrical magnets, surrounding one or more central lumens, separatedby a flexible wire section with a constant radius of curvature.

FIG. 5 illustrates an example of a catheter guidewire with twocylindrical magnets, surrounding one or more central lumens, separatedby a hinge-section.

FIG. 6 illustrates an example of a catheter guidewire with threecylindrical magnets, surrounding one or more central lumens, separatedby flexible wire sections.

FIG. 7 illustrates an example of a catheter guidewire wherein part ofthe guidewire near the distal tip has been permanently magnetized, andis constructed from stainless steel mesh integrated within the catheter.

FIG. 8 illustrates an example of a catheter similar to that shown inFIG. 7 with two permanent magnets, separated by a flexible wire section.

FIGS. 9A and 9B illustrate an example of a single magnet medical deviceinteracting with a system comprising a sensor array, a data acquisitionmodule, a signal processor and a display.

FIGS. 10A and 10B illustrate an example of a two-magnet medical deviceinteracting with a system comprising a sensor array, data acquisitionmodule, signal processor and display.

FIGS. 11A and 11B illustrate a top-view and side-view of a two-magnetcatheter guidewire in a blood vessel, showing the patient organ systemand patient boundary, and the sensor grid, respectively.

FIG. 12 is an example flow diagram for magnet localization using asingle magnet.

FIG. 13 is an example flow diagram for magnet localization with multiplemagnet that uses a precise rotational compliance model.

FIG. 14 is an example flow diagram for magnet localization with multiplemagnet that uses an approximate rotational compliance model.

FIG. 15 is an example flow diagram for a refinement process used inmagnet localization that uses M parameters.

FIG. 16 illustrates an example of a gantry robot for validating a singlemagnet localization system.

FIG. 17A illustrates an example of X-axis motion for the gantry robot inFIG. 16 .

FIG. 17B illustrates an example of Y-axis motion for the gantry robot inFIG. 16 .

FIG. 17C illustrates an example of Z-axis motion for the gantry robot inFIG. 16 .

FIG. 17D illustrates an example of θ-axis motion for the gantry robot inFIG. 16 .

FIG. 17E illustrates an example of ϕ-axis motion for the gantry robot inFIG. 16 .

FIGS. 18A and 18B illustrate validation plots for the gantry robot inFIG. 16 for θ=0 and θ=45, respectively.

FIGS. 19A and 19B illustrate an example of a wheel-in-wheel setup forsystem validation.

FIG. 20 illustrates an example of the three-dimensional error over 4096trials with different orientations of the medical device.

FIG. 21 illustrates an example of the distance between the positive poleprojection to the z-field peak in a two magnet system.

FIG. 22 illustrates an example of the dipole inverse cube law.

FIG. 23 illustrates an example of the curve family of the z-fieldcomponent along the line from z₁ ⁻ to z₁ ⁺ for varying z.

FIG. 24 illustrates an example of a two magnet physical therapy systemwith magnets mounted across flexible knee joint.

FIG. 25 illustrates an example of an eye tracking system with contactlens-mounted permanent magnets and goggles-mounted sensor array.

FIG. 26 is a flowchart of an example method for location and orientationof a medical device incorporating one or more permanent magnets.

DETAILED DESCRIPTION

Existing systems for in-body localization use fluoroscopy, which uses atime series of X-ray bursts each of which can provide partial positioninformation at a snapshot in time of the surgical device and the body.In this case, radiopaque elements are located on the distal end of thecatheter and repeated X-ray projections are taken to continuously updatethe image as the catheter is routed through the body. The result is atwo-dimensional image of the catheter which allows the physician toroughly determine the location of the catheter. There are significantlimitations and undesired properties of fluoroscopy.

-   -   (1) Fluoroscopic output gives an incomplete view of position and        orientation of the device within the body, as it provides only a        two-dimensional projection. A more complete imaging technique        should provide 3D position and orientation.    -   (2) Fluoroscopy during diagnostic and therapeutic procedures        inherently exposes the patient to unwanted and harmful ionizing        radiation. There is also a corresponding unwanted radiation dose        to the surgeon and surgical team. As a result, both the patient        and the medical team need to be heavily shielded, which        invariably interferes with the latter's movements during medical        procedures. Fluoroscopic X-ray measurements are repeated        typically over a repeated measurement rate of about 4 Hz to 20        Hz, to provide real-time visualization for the physician,        resulting in substantial total radiation dose throughout the        procedure. At the higher repeat rate (20 Hz), radiation dose is        greatly increased, while at the lower repeat rate (4 Hz), the        output image can appear to both lag in time and jump in space        during periods of significant motion.

Some methods have been developed which improve localization of radiationcompared to the conventional fluoroscopic system. These methods includeelectromagnetic systems, optical systems, magnetic systems, and acousticsystems. Existing systems which use magnetic localization techniquesinclude:

-   -   (1) Electromagnetic field generator beacons in a fixed reference        frame are combined with one or more medical-device mounted        magnetometer sensors. In these systems, drive signals are        applied to the electromagnetic beacons which send out        time-varying magnetic signals. These are typically continuous        alternating current (AC) signals where each magnetic beacon        broadcasts at its own frequency to make the signal from each        beacon distinguishable from all other beacons while all beacons        are driven simultaneously. Sensors means for measuring magnetic        field are mounted on the medical device, and there are        computational means for calculating individual field strength        and direction for a given generated field at each frequency,        analysis of phase-differences and cross-correlation between the        inputs.

In some embodiments, a magnetometer sensor includes a small-scalemicro-electromechanical system (MEMS) device for detecting and measuringmagnetic fields, which operates by detecting effects of the Lorentzforce—a change in voltage or resonant frequency may be measuredelectronically, or a mechanical displacement may be measured optically.

-   -   (2) Sequentially-applied magnetic gradient fields. These systems        typically use 3 large coil-pairs surrounding the patient aligned        orthogonally. The coils are sequentially driven in pairs to        produce a gradient field normal to the coil-pair axis, such that        the spatial position varies linearly with the value of the        magnetic gradient field in that direction. An estimate for one        directional component of position can be directly measured        during each coil-pair drive cycle.    -   (3) An electrical system that works analogously to the        sequentially-applied magnetic gradient field. This system        performs localization by observing a voltage gradient. Signals        are sequentially applied across electrode pairs to generate AC        electric fields sequentially on 3 different axes. Electrodes are        mounted on the in-body medical device which measure the voltage        compared with an externally applied reference voltage. When the        generator applies voltage on a particular axis, the spatial        information is encoded within the resulting voltage along the        generated electric field.    -   (4) Systems where electromagnetic signals are propagated between        one antenna on the tip of a medical catheter inserted in the        body and several antennas outside the body. The position and        orientation of the catheter tip are determined from the signals        transmitted between these antennas.

Existing systems for magnetic in-body localization use electromagnetswith controllable drive circuitry in order to enable and disable themagnetic field sequentially by axis, and to control the generated fieldfrequency in order to differentiate each individual radiator. This makesthe problem of localization computation easier in many ways, but alsopushes significant complexity and operating constraints onto other partsof the system.

Embodiments of the disclosed technology, among other features andbenefits, overcome at least the following limitations of currentsystems:

-   -   (1) External radiators often interfere with accessibility to the        patient.        -   (a) This is the case with coil pairs to produce magnetic            gradient fields. These systems are large and expensive,            typically completely surround the patient, and require a            dedicated surgical suite to be built around the system.        -   (b) Systems with magnetic beacons are mounted with some            beacons at or below the level of the patient and one or more            elements above the patient, which restricts the ability of            the physician to freely access the patient.    -   (2) A small form factor for the device-mounted localization        system components is critical. Any increase in the size of the        invasive medical device reduces the physician's options        regarding where within the body the device may be positioned.        This is a significant problem whether the device contains a        magnetic beacon or magnetic field sensors. In the case of        device-mounted magnetic beacons, the drive coils must be        precisely mounted within the invasive device, for example, at        the distal tip of a catheter guidewire. In the internal beacon        case, the applied signal and sufficient drive current must be        routed to the in-body radiator. This can be achieved with        additional wires to carry signal with significant current or        implemented with on-board drive circuitry and a radio-link. In        either case, there is a significant problem to be overcome in        implementing the beacon system in a space-constrained way. The        more common system choice is to have 3D magnetometer sensors        integrated within the invasive medical device, typically with        separate receive coils arranged along 3 orthogonal axes.        Associated with the receive coils are on-board low noise        amplifiers and signal wires between the internal device and the        rest of the system outside the body. The issue is compounded if        the system intends to locate more than one reference point along        the medical device. For a transmitting beacon, a separate drive        system and radiators must be embedded within the device for each        reference location. Alternatively, a separate set of sensing        coils or other magnetic field sensing devices must be integrated        for each internal device reference point.    -   (3) There is an additional problem with both radiating or        receiving coil-sets on the internal medical device, which is        also related to the size of the transmitters and/or receivers at        the reference points. The x, y, and z coils are not zero size.        This means that each of the single dimension coils and/or field        sensors is at a slightly different position within the device        than the intended reference position. Also, for best        maneuverability, it is highly desirable that the in-body device        be flexible, which can add an error to the relative orientation        of the coils making them no longer orthogonal.    -   (4) The best of these systems currently achieves positional        accuracy of 1-2 mm.

Embodiments of the disclosed technology provide, amongst other featuresand benefits, the following:

-   -   (1) Small footprint on-board the internal medical device;    -   (2) Allowing the physician and medical team unrestricted access        to the patient with no physical blockages due to the        localization system;    -   (3) Complete three-dimensional position and orientation        information of the device in the body;    -   (4) Elimination (or at least a significant reduction) of the        inherently harmful dose of ionizing radiation received by the        patient and surgical team during medical procedures; and    -   (5) Accurate position and orientation information (much better        than current state of the art 1 mm accuracy) at a consistently        high data rate for real-time visualization.

According to some embodiments, one or more reference positions on amedical device are localized, providing an estimate of both position andorientation. The device may be flexible, such that the orientations ofdifferent reference points on the device may be different. The disclosedsystems do not require radiating coils requiring drive current, receivecoils or other magnetic field sensing devices, but the localizationsystem can include one or more permanent magnets integrated within themedical device. This system does not require any device-mounted drivecircuitry, control logic, or additional wires to achieve localization ofthe medical device.

According to some embodiments, an array of magnetometer sensors measures3D magnetic field information at a plurality of reference locationsoutside of the in-body device. This sensor array defines a positionalreference frame for the magnetic location system. In some embodiments,the sensor array is planar, located below the patient, and can beintegrated with or attached to the operating table. In a planarconfiguration below the patient, the sensor array achieves the goal ofzero obstruction of physician access to the patient. The receive sensorarray may also be non-planar, so long as the sensor locations are known.

In some embodiments, the sensor array can be configured as a regularplanar grid with each sensor performing 3 orthogonal magnetic fieldmeasurements. In other embodiments, many other geometries can beimplemented. For example, the set of sensors can be planar but withirregular separations between the sense elements. The sense elements canalso be mounted arbitrarily in three dimensions, so long as positions ofthe sensor elements are known. For arbitrary sensor locations in x, yand z axes, the orientation of each sensor can also be arbitrary, as thefields from each sensor can be rotated via an individual mounting matrixfor each 3D sensor into a common sensor reference frame. Furthermore,the sensors do not need to include 3 orthogonal measurements taken atthe same location. For example, magnetometer sensors making a singlefield measurement along an axis can be used for the sensor array, aslong as projections of the individual measurement axes onto thecoordinate axes of the common sensor reference frame overlapsufficiently.

Embodiments of the disclosed technology exhibit improved performancewhen the permanent magnets of the surgical device lie approximatelywithin the x-y bounds defined by the outer sensors in the sensor grid,and when the height above the grid is less than or equal to twice thex-y grid width. Measured accuracy error increases as the permanentmagnets are moved outside of this guideline work volume. However, thereis a graceful degradation in performance as the magnets move outside theaforementioned work volume.

Electrophysiology (EP) catheters are specialized catheters, which aredesigned to be used with compatible stimulators and/or amplifiers toperform standard electrophysiology studies. Depending on the features ofthe stimulator/amplifier, pacing and recording protocols can beperformed from inside the heart (intracardiac) or through the esophagus(transesophageal) to determine electrical properties of the atrium andthe ventricle, which include:

-   -   Conduction times    -   Refractory periods    -   His potentials    -   Sinus and atrioventricular nodal properties    -   Inducibility of abnormal heartbeats

Embodiments of the disclosed technology enable the localization of EPcatheters based on the catheters being configured with one or morepermanent magnets. FIGS. 1 and 2 show examples of EP catheters with oneand two magnets, respectively. As illustrated therein, the catheters canbe configured to include one or two permanent magnetic dipoles (e.g., abar magnet with positive and negative poles separated by a distance).FIG. 3 shows an example of a catheter guidewire with a cylindricalmagnet surrounding one or more central lumens.

Examples of Medical Devices Incorporating One or More Permanent Magnets

In some embodiments, using a single catheter guidewire-mounted permanentmagnet and a planar array of 3D magnetometer sensors results in anaccuracy in locating the catheter position of <0.3 mm. In otherembodiments, using two permanent magnets on a flexible catheterguidewire results in a simultaneous accuracy for both permanent magnetsof <0.3 mm. In both of these example embodiments, reference locationsare updated without noticeable delay, at, for example, a 50 Hz rate.

In the multiple (two or more) magnet embodiments, the section ofcatheter guidewire between the two magnets can be flexible (asillustrated in FIG. 4A), so that each magnet along the wire may have aunique angular orientation.

In some embodiments, the wire rotational compliance is a function ofposition along the wire. In this case, the radius of curvature at eachpoint is inversely proportional to the distributed compliance value atthat point. Alternatively, the radius of curvature is proportional tothe distributed rotational stiffness (1/rotational compliance) at eachpoint along the wire. The rate of change of deflection at each point isproportional to the compliance multiplied by the bending moment.

In some embodiments, the distributed compliance along the flexiblesection of the wire is constant throughout the flexible section boundedby the proximal and distal magnets. In this case, the shape of theflexible wire segment between the permanent magnets is a circular arc(as illustrated in FIG. 4B).

In some embodiments, the catheter guidewire flex is implemented as asingle hinge-point with rigid sections proximal and distal to the hinge,with the two magnets on either side of the hinge (as illustrated in FIG.5 ).

According to some embodiments, in the two-magnet configurations (e.g.,the examples illustrated in FIGS. 4A, 4B and 5 ), the positions andorientations of the magnets can be accurately described with 7parameters: x, y, and z for first magnet center, theta (θ, azimuth offirst magnet, corresponding to rotation around the x-plane), phi (φ,elevation of first magnet), a deflection parameter α, and a rotationangle eta (η) of the two magnet system about the first magnet axis. Withthe correct value of the deflection parameter α, and a model of thedistributed mechanical compliance along the wire, the complete curve ofthe flexible wire section between the two magnets can be correctlymodeled.

Example embodiments that are described using the 7-parameter model usethe following set of parameters: x, y, and z for Magnet 1 (M1) position,theta (yaw-angle) corresponding to rotation about the reference framez-axis (wherein a 0 value for yaw means x-y plane projection of magneticaxis is along the x-axis), phi (elevation, wherein a 0 elevationcorresponds to magnet axis in the x-y plane and a pi/2 radian elevationcorresponds to magnet axis along z-axis), eta rotation about the M1axis, and the deflection parameter a.

In the example of the two-magnet hinge embodiment (illustrated in FIG. 5), the deflection parameter α is simply the angle made by the hinge.

In some embodiments, more than two magnets can be incorporated along theflexible section (as illustrated in FIG. 6 ). As in the two-magnet case,the wire has a distributed compliance as a function of distance alongthe flexible section and the shape of the flexible section is determinedby the bending moment and the distributed wire mechanical compliance.The path lengths along the wire between each magnet are known so thatthe relative magnet positions can be calculated given the flexiblesection wire shape resulting from the bending moment and the flexiblewire distributed mechanical compliance. This method can be extended toany number of fixed magnets.

In some embodiments, the distributed wire compliance model may be asimplification of the true wire distributed compliance, such that thebest fit deflection parameter α does not yield an exact solution of theflexible wire shape. In this case, the calculated permanent magnetpositions and orientation will also not be exact. Herein, precisepositions and orientation of each magnet will require an additionaloptimization stage. Using an exact model includes two stages: a firststage that uses geometric feature extraction to determine approximateparameters, which are input into the second stage that implements anoptimization of the 7-parameter model.

However, when the combination of distributed mechanical compliance andbest fit deflection parameter are not exact, a three-stage approach canbe used. The first two stages are the same as described above, and thenthe third stage includes passing the approximate 7-parameter estimate toa more general 5×N dimensional optimizer, where N is the number ofmagnets. In this optimizer, each magnet's x, y, and z positions, as wellas azimuth and elevation parameters, are independent. Given the7-parameter model, the x, y, and z coordinates for the positive andnegative poles of each magnet can be calculated. Each pair of poles (foreach cylindrically symmetric dipole magnet) can then be described withthe 5-parameter model used for the single magnet system, with the x, y,z, theta and phi parameters being relative to the sensor referenceframe. Thus, for a two-magnet system, this is a 10-dimensionaloptimizer, for a 3 magnet system this is a 15-dimensional optimizer, andso on. In order for the optimizer to reach the correct answer, theclosest minimum for the 5×N-dimensional error function must also be theglobal minimum. The intermediate 7D optimizer is configured to find aset of parameters close enough to the global minimum so that the 5×Ndimensional error optimization will converge.

In some embodiments, one or more permanent magnets are mounted on thecatheter guidewire as hollow cylindrical collars leaving the guidewirelumens unobstructed. In other embodiments, the one or more permanentmagnets are mounted along the geometric axis of the guidewire near thedistal tip, which blocks the central lumen at that point. Thisconfiguration can be used with catheters that travel on the outside ofthe guidewire, such as a balloon catheter.

In some embodiments, the catheter guidewire is itself permanentlymagnetized so that one or more sections of the guidewire become thepermanent magnets in the system. This can be a section of stainlesssteel mesh integrated with the catheter guidewire (as illustrated inFIGS. 7 and 8 that show the one and two magnet variations,respectively). This embodiment provides a very compact footprint for theon-device permanent-magnets, as no additional material is added beyondwhat would already be present in a conventional guidewire. In someembodiments, the magnetized catheter guidewire sections are stainlesssteel.

Example Prototypes

FIG. 9A illustrates a permanent dipole magnet interfacing with theprototype system that includes the microchip controllers and the64-element (8×8) grid of sensors. FIG. 9B shows the microcontrollerchips being configured to collect the magnetometer data and pass it to asignal processor comprising one or more computational modules (describedin further detail below), which estimates the position and orientationof the medical device, and provides this information to a user using thedisplay illustrated in FIG. 9B.

FIGS. 10A and 10B are similar to the framework illustrated in FIGS. 9Aand 9B, and illustrate a two-magnet medical device interfacing with theprototype system.

FIGS. 11A and 11B illustrate a top-view and side-view, respectively, ofa two-magnet catheter guidewire in a phantom blood vessel, showing thepatient organ system and patient boundary, and the sensor grid. A systemfor estimating the position and orientation of an invasive surgicaldevice, e.g., the illustrated catheter guidewire with two permanentmagnets, relative to a reference frame, comprises:

-   -   (1) one or more permanent magnets mounted on the surgical        device;    -   (2) multiple magnetometer sensors at fixed locations (e.g.,        forming a sensor grid and providing a reference frame);    -   (3) the multiple magnetometer sensors can be configured to        perform magnetic field measurements of the direct current (DC)        superposition field of the one or more permanent magnets; and    -   (4) one or more processors for receiving the input signals and        calculating the position and orientation of the one or more        permanent magnets mounted on the surgical device.

Examples of Computational Modules for the Disclosed Technology

FIG. 12 is a flow diagram of an example method for localization of asingle permanent magnet. As illustrated therein, the localizationprocedure for a medical device comprising a single permanent magnetbegins with initializing the sensor grid state, and loading the magneticmodel constraints and initial parameter estimates. In an example, thedata collection rate for an 8×8 sensor grid is every 20 ms. In someembodiments, each datum that is collected may be processed. In otherembodiments, the collected data may be downsampled (or upsampled) priorto processing.

If the most recently computed convergence metric is less than apredetermined threshold, then the refinement procedure (further detailedin FIG. 15 ) is performed. If not, then the following series ofoperations (which constitute the geometric feature extraction processthat is detailed later in the document) are performed prior toperforming the refinement procedure:

-   -   (a) the “first line of zeros” is estimated;    -   (b) the initial pole axis search is performed with a constrained        orientation range;    -   (c) the “second line of zeros” is estimated; and    -   (d) the residual error minimization along the target axis is        performed.

The refinement procedure is followed by estimating the model parameters(e.g., x, y, z, theta and phi) and the convergence metric. The estimatedparameters are displayed as well as used to update the predicted sensormeasurements in the feedback path illustrated in FIG. 12 .

FIG. 13 is a flow diagram of an example method for localization ofmultiple (two or more) permanent magnets (N≥2) with an exact rotationalcompliance model. The flow diagram in FIG. 13 is similar to the flowdiagram described for the single-magnet system in FIG. 12 . However, incontrast to the single-magnet system that uses a 5-parameter model, a7-parameter model (that includes the additional parameters alpha andeta) is used for the geometric feature extraction and refinementprocedures.

FIG. 14 is a flow diagram of an example method for localization ofmultiple (two or more) permanent magnets (N≥2) with an approximaterotational compliance model as an intermediate step, followed by a5×N-dimensional refinement stage. Both flow diagrams in FIG. 13 and FIG.14 use a 7-dimensional refinement process based on partial derivatives.However, in FIG. 13 , this refinement process provides the finalestimate, while in FIG. 14 , the 7-dimensional refinement output is anintermediate step (that is referred to as an intermediate stage in thisexample) and is followed by a 5×N-dimensional refinement stage that alsouses partial derivatives. This enables parameter estimation of the5-parameter model for each dipole magnet of the N magnets.

FIG. 15 is a flow diagram of an example method for the refinement stagewith M parameters, and is detailed later in the document.

According to some embodiments, operations in the flow diagramsillustrated in FIGS. 12-15 include:

-   -   (1) Magnetic field measurements taken at each sensor within the        sensor array.    -   (2) Removal of earth and environmental magnetic field from each        set of sensor measurements. In an example, for improved        accuracy, each magnetometer can be individually calibrated with        6- or 10-parameter calibration for hard and soft iron        impairments.    -   (3) An approximate initial solution based on the measurement of        geometric parameters of the system.        -   (a) In some embodiments, specific features corresponding to            system geometry are found within the sensor array data,            leading to initial position and orientation estimates. This            approach applies to systems with one or more permanent            magnets.        -   (b) In some embodiments, a best fit for the one or more            permanent magnets is determined from a look-up table.        -   (c) In some embodiments, the geometric features and table            lookup method position and orientation estimates are            blended.    -   (4) Generating a parameterized model representing estimated        permanent magnet position parameters.        -   (a) In some embodiments, e.g., illustrated in FIG. 12 , the            model has 5 parameters, representing x, y, and z position of            a single cylindrical dipole magnet plus azimuth and            elevation. In the case of a cylindrical magnet, the rotation            about the magnet axis does not change the resulting magnetic            field, so this parameter does not need to be modeled. By the            convention chosen, for zero theta (yaw rotation about            z-axis), the magnetic poles are aligned in the sensor            reference frame x-direction, with x position of the positive            magnetic pole less than the x position of the negative            magnetic pole.        -   (b) In some embodiments, e.g., for two permanent magnets            with a hinge between them as illustrated in FIG. 5 , the            model has 7 parameters, representing x, y, and z, theta and            phi positions of one permanent magnet with a rigid section            leading to hinge, the sixth parameter being the deflection            angle of the hinge, and the seventh parameter being the            rotation angle about the first magnet axis.        -   (c) In some embodiments, in the context of FIGS. 13 and 14 ,            two or more permanent magnets may be mounted on a flexible            section of guidewire, wherein the shape of the guidewire            matches a circular arc-segment, which has constant curvature            along the flexible section of the wire. In this case, the            angle of bend of the guidewire is proportional to the            cumulative path length along the flexible section of            guidewire. Over this section with constant curvature            constraint, the orientation of the mounted or incorporated            permanent magnets is linearly proportional to the length of            the wire path separating each magnet. If the constant            curvature constraint is adhered to precisely, a two or more            magnet system can be modeled with a 7-parameter system,            including x, y, and z positions, and theta and phi values            for one magnet, plus a rotation parameter eta being the            rotation angle about the first magnet axis, and the seventh            parameter α being the radius of curvature of the flexible            section between the magnets.        -   (d) In some embodiments, e.g., in the context of FIG. 13 ,            two magnets may be separated by a flexible catheter            guidewire section, with only an approximate curvature            constraint on the flexible guidewire section and distance            constraints between the two magnets. This requires a model            with 10 parameters, i.e., x, y, z, azimuth and elevation            separately estimated for both magnets. Since there is an            approximate curvature constraint in this embodiment, an            intermediate 7-parameter optimization can be performed to            give a best fit 7-parameter solution, which can be used as            an input for a full 10-parameter optimization to yield x, y,            z, theta and phi for each magnet independently.        -   (e) In some embodiments, a wire with approximate constant            curvature or other modeled constraints may include three or            more magnets along the flexible guidewire section. Like the            two-magnet system, this system can be modeled with the same            7-parameter model including x, y, z, theta and phi for first            magnet, rotation around first magnet axis, and the radius of            curvature along the section between the first and last            permanent magnet.    -   (5) Candidate model parameters can be used to predict the        corresponding locations of each magnetic pole and the resulting        magnetic field measurements at each sensor in the receive sensor        array.    -   (6) A convergence metric, representing the difference between        the set of field measurements at each element of the sensor        array and the predicted field measurement for each element of        the sensor array, can be calculated. The convergence metric is a        function of the set of differences between the measured values        and the predicted values.        -   (a) In some embodiments, the convergence metric is not a            linear function.        -   (b) In some embodiments, the initial location estimates of            position and orientation are a blend of the geometric            feature analysis and the table lookup method, with the            relative weights of each method determined by the            convergence metric.    -   (7) After initial position and orientation estimates have been        made, precise estimates are made using a refinement stage (e.g.,        illustrated in FIG. 15 ) which successively updates the best        candidate model parameters using the set of partial derivatives        of the convergence metric relative to changes in each parameter,        such that the system attempts to drive the convergence metric        toward zero.        -   (a) In some embodiments, the absolute magnetic field            strengths of the permanent magnet or magnets are used in the            convergence metric.        -   (b) In some embodiments, the measured and predicted magnetic            fields are normalized relative to each other such that the            total energy in the set of measured field value matches the            total energy in the set of predicted field values.    -   (8) In the case where the amount of motion from one snapshot in        time to the next is small, the initial geometric estimator can        be skipped, and the system can proceed directly to the        refinement stage. This is analogous to the continuous tracking        mode following initial acquisition for a GPS navigation system.        -   (a) In some embodiments, the choice of whether to perform            full position acquisition or continue with tracking mode is            made by calculating the convergence metric between the last            estimated location and the new set of measurements. The            tracking mode is used if this metric is below a threshold.

Example Validations and Experimental Results

Single magnet system. Single magnet accuracy was validated using agantry-style robot (as illustrated in FIG. 16 ) with 5 degrees offreedom. Independent control was provided for x, y, and z positions forthe magnet geometric center (illustrated in FIGS. 17A, 17B and 17C,respectively), along with theta rotation about sensor z-axis(illustrated in FIG. 17D) and rotation of a cylinder containing themagnet to achieve desired tilt relative to the sensor x-y plane(illustrated in FIG. 17E). A hole was drilled within the centralcylinder leaving space for the dipole magnet, which is installed in thegeometric center of the cylinder. Individual set screws on each side areused to complete the central alignment of the dipole magnet within thecylinder.

For the two single magnet plots (illustrated in FIGS. 18A and 18B), z isheld constant, and positions along the x and y axis are measured withcommanded position truth points separated by 5 mm. For plot in FIG. 18A,the theta rotation angle about the sensor z axis is 0 and for the plotin FIG. 18B, the theta rotation angle about the sensor z axis is 45degrees. For these two test cases, the 3D root mean square (RMS) errorin position was measured to be 240 microns and 297 microns,respectively. In the plots, the truth points are marked in green and themeasured points are marked in orange.

Two-magnet system. Validation of the two-magnet system was conductedusing a wheel-in-wheel system (illustrated in FIGS. 19A and 19B)combined with a plug-board to precisely align position and orientationtruth with the sensor grid reference frame. As illustrated therein,there are plug-board style holes at 5 mm increments to receive the setof 4 standoffs protruding from the bottom of the wheel in wheelapparatus. This provides precise alignment of the x-y position for thenegative pole of the centrally mounted permanent magnet M1. With the M1negative pole mounted directly in the center of the large circle, thecircle can be rotated while the x-y position of the M1 magnet negativepole is unchanged. A second magnet is mounted inside a second smallercircle whose center lies along the magnetic axis for M1. The secondmagnet M2 is mounted such that the outer edge of the small circle isaligned with the positive pole of the second magnet M2. Rotation of thelarge circle changes location truth for the theta angle and rotation ofthe small circle changes location truth for the alpha deflection angle.The z-height for this system is set by adding additional sets of 4identical height standoffs.

FIG. 20 illustrates an example of the sorted three-dimensional errorover 4096 trials with different orientations of the medical device. Thetrials were performed using a two-magnet flat test apparatus with an 8×8grid with a 1.76 cm spacing, varying over x, y, z positions and θ, Φ, α,η angles, and which resulted in an RMS error that was measured to be 192microns.

Additional Embodiments of the Disclosed Technology

Single-magnet system. In some embodiments, a single permanent dipolemagnet is mounted on a surgical device, for example, a catheterguidewire. The guidewire is navigated within the patient to the targetarea (e.g., illustrated in FIGS. 11A and 11B for the two-magnet system).While the guidewire with the permanent dipole magnet moves through thepatient, an array of magnetic field sensors measures the vector fieldcomponents at a plurality of locations on the sensor grid. The systemuses a series of increasingly precise methods to map the set of magneticfield measurements to a best fit estimate of the position andorientation parameters of the catheter guidewire mounted permanentmagnet.

For the single magnet system, a close approximation for magnet x, y, andz position, theta rotation of the magnetic pole axis about the sensorz-axis (theta) and tilt of the magnetic pole axis relative to the sensorx-y plane (phi) can be calculated using geometric feature extractionmethods. Once these initial approximations have been made, the estimatesare passed to a refinement stage which successively improves the modelparameter estimates by constructing field predictions that would arisefrom the model parameters, calculating an error metric of the set ofdifferences between each field measurement and its correspondingpredicted measurement at a given sensor location. The model issuccessively updated by following the error gradient along the set ofpartial differential changes in error metric as a function of eachindividual parameter. This refinement stage continues until convergenceno longer improves or until a maximum number of iterations has beenreached or exceeded.

Geometric feature extraction. For the single dipole magnet case, 5parameters sufficiently describe both the position and orientation ofthe permanent magnet. The convention adopted is that position is definedby the midpoint of the magnet, equidistant from the positive andnegative magnetic poles, which covers the x, y and z parameters.Additionally, angles theta and phi are used, wherein phi is pitch anglerelative to the horizontal plane (x-y plane defined by the sensor grid,such that at zero phi, the z positions of the positive and negativepoles are the same) and theta is a rotation about the reference z axis.For a general object in 3D space, there would be a third rotation.However, in the single magnet system, this is a rotation about themagnetic axis (line between positive and negative poles), and themeasured magnetic field does not change at all in response to rotationabout this axis. Thus, this parameter does not need to be included inthe model.

In some embodiments, it is, in theory, possible to do a brute-forcesearch across the 5 model parameters, but this quickly becomescomputationally expensive. Large computational savings can be achievedif this 5D search can be serialized into lower-dimensional searches.

In some embodiments, this 5D search can be efficiently subdivided.

-   -   (a) In a first step, the “first line of zeros” is computed,        which corresponds the best fit line project of a dipole magnetic        field onto the planar sensor grid, and which is computed using a        2D search. In an example, this reduced complexity search uses an        approximate pole axis search (pair of peak values for +z and −z        magnetic fields). Determining the “first line of zeros” yields        an estimate for the theta angle parameter and enables the        determination of the line in the x-y plane that contains the x        and y position values for the permanent magnet. Thus, two of the        parameters are determined in this first step.    -   (b) The second step leverages the fact that in the plane which        bisects the positive and negative pole locations for the dipole        magnet, the field is identically zero. For a non-zero phi angle,        it is observed that a “plane of zeros” intersects the x-y plane        defined by the sensor grid as a line, and that the direction of        this line is perpendicular to the first line of zeros. Herein,        it can be noted that:        -   A line can be drawn from the x-y plane intersection point of            the two features ((i) the first line of zeros and (ii) the            intersection of the x-y plane with the plane of zeros) back            to the dipole magnet center. The desired line is in the            plane defined by the first line of zeros and the sensor            z-axis.        -   The tilt angle relative to the z-axis can then be determined            to be used to draw the line from the intersection point in            x-y plane back to center of dipole magnet. If the tilt angle            is correct, the magnetic field normal to both the second            line of zeros and the tilted line in the plane defined by            first line of zeros and z axis is uniquely zero at all            points along the line. In the case of 0-tilt angle, the            sensor plane intersection of the first line of zeros and the            second line of zeros gives the correct x and y position of            the magnet. For all other angles, the x and y position of            the magnet is offset from this intersection point. The            correct tilt angle is 90 degrees different than the desired            phi parameter, which can thus be determined using a            1-dimensional search, constructing the field measurements            along the second line of zeros, and determining the tilt            angle that minimizes the total field energy in the candidate            direction. This provides the phi estimate.        -   Finally, the distance along the line from the x-y plane            intersection of first line of zeros and the plane of zeros,            to the dipole magnet center is determined based on a            1-dimensional search that searches for the best agreement            between the measured fields and the predicted fields along            this line. In an example, the minimum value of a convergence            metric along this line will correspond to the x-y-z dipole            magnet center.

Feature extraction and table lookup method. It is noted that whateverpattern is generated in the magnetic fields will be rotated andtranslated with whatever rotation and translation is performed on thedipole magnet for translation in x and y and rotation in theta. Thismeans that if there are features that can be extracted in a systemconstrained to a particular set of x, y and theta, they can be mapped toa different arbitrary set of x, y, and theta, such as x=0, y=0, theta=0(for convenience of calculation). This leaves only 2 values undefined:phi (elevation) and z (height above the sensor grid).

If the rotatable and translatable constraint at x=0, y=0, and theta=0 ismaintained, metrics can be defined as being constructed as a function ofthe magnetic field measurements, phi and z. There are many differentmetrics that can be constructed from these inputs, but the goal here isto define a set of metrics such that over the full range of phi and zinputs, there is a useful mapping back from the calculated metrics to anestimate for the phi and z pair. It is noted that a single metric maynot provide a good one-to-one mapping back to the phi/z pair over theentire range of the search, so it may be advantageous to use differentmetrics over different combined ranges for the phi/z pair.

In an example, the phi/z pair may be characterized using one or more ofthe following functions: pos_peakx, neg_peakx, pos_neg_ratio, peak_sep,2Dmag_peak, and 3Dmag_peak.

In some embodiments, and given the calculated metrics, the optimal phi/zpair can be determined by searching along z. In an example, thisincludes

-   -   (a) selecting a candidate value for z;    -   (b) given the calculated metrics, use the table to perform an        interpolated lookup of the best phi value corresponding to the        metric set and the z candidate;    -   (c) calculate the convergence error between the predicted field        measurements that would result from this combination of phi/z        and the actual measurements; and    -   (d) determine the best value for z by following the gradient of        the convergence error toward its minimum. This gives us the        estimates for phi and z.

The aforementioned description results in estimates for phi, theta andz, and an equation for a line containing x and y. Given that themetric/table model can be rotated in theta and translated in x and y,the distance along the identified first line of zeros relative to thetable origin can be calculated. The field metric tables provide multipleestimates of this remaining offset. For example, the pos_peakx value isthe distance along the first line of zeros in the x-y plane between thedipole magnet's geometric center and the location of the field peakvalue along the direction defined by the first line of zeros. Thus, xand y values can be estimated by starting with the x-y position of thepeak of the 2D field magnitude (in x and y), then moving in thedirection of the first line of zeros by an amount equal to pos_peakx.

In some embodiments, the geometric feature extraction method can be usedto derive the five parameters. In other embodiments, the featureextraction and table lookup method can be used to derive the fiveparameters. In yet other embodiments, both methods are used and theindividual x, y, z, theta and phi parameter estimates are blended byperforming a weighted average of the convergence errors of each method.

In an example, a convergence error is defined as follows: for eachmeasured sensor location, there exists a measured magnetic field valuefor x, y and z. For a given set of model parameters, the predictedmagnetic field values for x, y and z at the same set of sensor locationscan be calculated. Then, calculating the sum of (xmeas−xpred)²,(ymeas−ypred)², and (zmeas−zpred)² across all locations provides anerror metric for the first geometric feature extraction method and asecond error metric for the second table-lookup method. For each of the5 parameters, the blended parameter estimate will be

Param_method1*(error_sum2/(error_sum1+error_sum2))+Param_method2*(error_sum1/(error_sum1+error_sum2)).

Refinement process. The goal of the above two methods is to provide aset of parameter estimates that are close enough to the true (real)values such that the closest local minimum of a defined convergencemetric is in fact the global minimum. In some embodiments, a refinementstage (illustrated in FIG. 15 ) is an N-dimensional partial derivativedriven convergence method, whose implementation includes scaled ranges,initialization, and auto-calibration. The initialization procedure forthe refinement process includes:

-   -   (a) setting initial conditions for candidate parameter values.        In an example, these can be from an intermediate optimizer. In        another example, they can be generated by a geometric estimator.        In yet another example, they can be default values;    -   (b) calculating predicted field measurements at sensor locations        given initial parameter values;    -   (c) calculating a starting convergence metric based on        differences between measured field values at sensors and        predicted sensor values;    -   (d) setting a list of relative scale factors for the model        parameters. In an example, the scale factors should be set so        that the ratio of update gain to total expected parameter range        is about the same for all parameters. In some embodiments, if        the scaling is mismatched, the refinement process operates        sub-optimally;    -   (e) setting a second global gain factor. In an example, the        variable global gain factor and the constant per parameter        initial scale factors will be used as a combined scale factor        for correction gain after calculating the set of partial        derivatives of the convergence metric relative to each        parameter. The set of partial derivatives is normalized to have        the sum of squares of scaled partial derivatives scaled to one;    -   (f) calculating a new set of candidate parameter values and        convergence metric;    -   (g) accepting the new candidate parameter values if the        convergence metric for the new candidate is better than the        prior best (allowing for slight increase in the global scale        factor);    -   (h) rejecting the new candidate parameter values if the        convergence metric for the new candidate is not an improvement,        and reducing the overall variable system gain based on the        assumption that the current step sizes are too large. In an        example, the gain is divided by two;    -   (i) completing the process if the system gain has decreased        below a minimum threshold or if a maximum number of iterations        have been exceeded; and    -   (j) outputting the best parameter values and final convergence        metric.

In operation (h) of the above process, it is noted that the system gainis not reduced, and it may be increased slightly to improve convergenceof the algorithm.

The refinement technique described above will work for any number ofdimensions so long as the convergence metric local minimum function of Ndimensions is also the global minimum. Thus, the refinement stage can beextended to perform an auto-calibration procedure on geometricparameters that may not be perfectly known, such as the pole separationdistance of the dipole magnet and the absolute strength of the dipole.

In an example, if a good (but not exact) estimate of pole strength andseparation distance is available, they could be included directly in thesame optimization used to find values for the other parameters. However,if good estimates do not exist, then it is preferable to first performthe 5D optimization on x, y, z, theta and phi, and once these haveconverged to a minimum value using the assumed values for poleseparation and magnetic field strength, add these last two parameters tothe optimization model (now 7D) and re-optimize.

Multiple-magnet system. In some embodiments, computing approximate modelparameters for a two-magnet system includes operations similar to thosefor the single-magnet systems. Some geometric features can be extractedby treating the magnets separately, while others require differentmethods. Some examples of geometric features that can be computed in themultiple-magnet system include, but are not limited to, the following:

-   -   (a) Magnitude peak estimates for x-y projection of magnet        coordinates        -   The maximum magnitudes of the total magnetic field occur            near the sensor grid points that are closest to the magnets.            For z parameters that are small compared to the grid            spacing, there are two distinct peaks per magnet: one near            each pole. As z increases, the individual poles are no            longer resolvable from the magnitude, and there is only one            peak per magnet.        -   For each magnet, the x and y location of the magnitude peak            approximates the projection of the center point onto the x-y            plane. These estimates have errors caused by the other            magnet and by the spacing of the measurements. As the            magnets' z increase, the errors increase as the influence of            the other magnet grows.        -   Since the sensor grid spacing has a similar scale to the            dimensions of the magnets themselves, some embodiments are            configured to improve the precision of the estimated peak            locations. In an example, polynomial interpolation can be            used to approximate intermediate values between the            measurements at the sensor locations. An upsampling factor L            is selected and a finer grid of points is computed by            fitting a polynomial function to the existing data points.            For well-behaved functions such as the magnetic field            strength, the approximation can be quite close to the            correct values. This technique can mitigate some of the            effects of the coarseness of the sensor grid. It is            important to note that interpolation is most useful close to            a pole, where magnitude changes are larger and not            complicated by other influences.    -   (b) Peak total field magnitude estimates for magnet z coordinate        -   When the distance to the dipole magnet is much greater than            the pole separation distance, the dipole's field magnitude            varies with the distance r as 1/r³ as r increases (as            illustrated in the example in FIG. 22 ). For measurements            taken much closer to the dipole magnet, if the distance to            one pole is significantly less than the pole separation            distance, the near pole dominates and the field drops off as            approximately 1/r². In the transition region between the            far-field and the near-field, the power-relationship is            in-between the two bounding cases. Inverting this            relationship allows the distance to be estimated from the            field strength at the peak coordinates. Since the peak is            close to the magnet center's projection, this distance is an            estimate of the z parameter (as illustrated in the example            in FIG. 21 ).        -   At each sensor location, the z component of the magnetic            field has contributions from the four magnetic poles. The            closer a sensor is to one of the poles, the stronger the            influence of that pole, and the smaller are the errors due            to neglecting the others.    -   (c) Magnetic field z component estimates for theta angles for        each magnet        -   Maxima of the z field components, denoted by z₁ ⁺ and z₂ ⁺,            approximate the x-y plane projections of the magnets' plus            (or north) poles when z is small compared to the pole            spacing. Conversely, the minima of the z field are denoted            by z₁ ⁻ and z₂ ⁻ and approximate the minus (or south) poles            when the magnet is close to the plane. The extrema move            progressively farther apart as z is increased, so their            locations cannot be used as a direct estimate of the            location without compensating for z. In principle however,            the line between a magnet's z plus and z minus peaks lies            along the projection of the magnet's axis and can be used            directly to estimate the theta parameter. FIG. 23            illustrates an example of the curve family of the z-field            component along the line from z₁ ⁻ to z₁ ⁺ for varying z.        -   Significant discrepancies in the z field peaks of each            magnet are caused by the influence of the other magnet. As            the z field is just one component rather than the total            magnitude, effects that tend to rotate the field vector            contribute directly to errors in a single component. These            discrepancies are greatest for the center two poles, that            is, for z₁ ⁻ and z₂ ⁺, which are substantially affected by            all the other poles. Since the peaks due to these poles tend            to get closer together as z increases, they become            indistinguishable from each other for larger values of z.            The peaks due to the outside poles z₁ ⁺ and z₂ ⁻ how much            greater amplitudes and are much more easily discernable due            to their greater distance from the other magnets.        -   Instead of trying to distinguish separate peaks for the two            center poles, the direction of fastest change away from the            outside peaks is used to estimate the line along which the            corresponding inside peak would lie. Values of the            directional derivative (defined as the dot product of a unit            vector with the gradient) are computed for points in a            circle pointing away from the outside peak. Close to this            pole, the z field changes most along the projection of the            magnet's axis before other poles start influencing the            field. This direction of greatest ascent gives a direct            estimate of the angle between the magnet's z peaks.        -   To determine the distance from the outside pole to its            corresponding center pole, the point along the line of            greatest ascent (or descent) is found where the first            difference of the gradient magnitude is a minimum. This is a            characteristic of an inflection point, a point at which the            rate of change is constant. For the case of an opposite            charge tending to cancel out the center pole, this is the            farthest point before the other magnet starts exerting            equivalent influence over the field. The distance along the            gradient line provides an estimate of the center pole's            location.    -   (d) Associate magnitude peaks with their corresponding z plus        and z minus peaks        -   May be used as an independent calculation to improve            robustness.        -   When multiple maxima and minima are found for total            magnitude and z field component, these points are grouped            into a triplet that represents one magnet. Naïve approaches            such as taking the closest peaks can fail for the two center            poles for larger values of the alpha parameter.        -   Create an exhaustive list of the possible groups of every            magnitude peak with a z plus and a z minus peak. For each            possible association of every magnitude peak with a z plus            and a z minus, compute the sum of the distances from the            magnitude peak to z component peaks. Select the grouping            with the smallest total sum.    -   (e) Distinguish magnet 1 peak groups from magnet 2 peak groups        -   The arrangement of the magnets with magnet 1's plus pole at            the edge, magnet 1's minus pole and magnet 2's plus pole in            the center, then magnet 2's minus pole at the other edge            allows the two magnets to be distinguished.        -   For an arbitrary selection of z1 and z2, compute vectors            from z1_plus→z1_minus→z2_plus and z2_plus→z2_minus→z1_plus.            Because the alpha parameter ranges from −90 to 90 degrees,            only the z2-to-z1 vector will point in the opposite            direction from its plus-to-minus vector.        -   Find the angle between these pairs of vectors and compare            them. If M1 and M2 have been chosen correctly, the z1→z2            angle will be greater than the z2→z1 angle. If this relation            does not hold, the magnets have been switched.

In some embodiments, computations can be implemented for a parameterizedcurve for the flexible guidewire section. Herein, it must be noted thatalthough curve families that can be traced by a flexible interconnectsection between two magnets can be precisely characterized, small errorsin the curve family equations translate to overall position errors.However, if the curve family is fairly close, the 7D optimization can beperformed to be close enough so that the 7-parameter system estimate canbe converted into a 10-parameter model estimate, which is followed by afinal 10D refinement stage (e.g., in the context of FIGS. 14 and 15 ).This approach may be used for two or more magnets, and includes pickinga curve shape for the flexible guidewire section, e.g., a section of anarc corresponding to a constant curvature along the flexible section,and perform a 7D parameter estimation for the extremal points. In anexample, this approach is characterized by:

-   -   (a) the alpha deflection angle mapping to an ellipse rather than        a single hinge deflection;    -   (b) the predicted signal using three or more magnets in the        model, and x, y, and z being calculated for each of the 6        magnetic poles from the 7-parameter model; and    -   (c) the 7D model providing a fairly good estimate (if, for        example, the assumed curve shape of the wire is not a perfect        match for the actual wire shape), and a 15D optimization being        able to converge to the correct values.

In some embodiments, the computations may be performed with twothresholds: a low threshold and a high threshold. If convergence metricis greater than the high threshold, then the final refinement isperformed. If, however, the convergence metric does not exceed the highthreshold but is greater than the low threshold, the intermediaterefinement may be performed.

According to some embodiments of the disclosed technology, a three-stageapproach to generate position and orientation estimates for an N-magnetsystem with an approximate rotational compliance model comprises:

-   -   (a) an initial geometric feature extraction;    -   (b) a 7-parameter model extraction (also referred to as an        intermediate refinement, which can be exact in some cases, but        approximate in the general case, but much more accurate than the        initial geometric feature extraction); and    -   (c) a 5D×N partial derivative refinement, with N permanent        magnets with some bounding constraints on the relative        orientations of the N magnets.

In some embodiments, there will be non-zero errors in the physicaldimensions of the guidewire, the mounting locations and orientations ofthe permanent magnets relative to each other, the magnet lengths andtheir field strengths. If uncorrected, these will contribute error tothe overall location estimate. In this case, the model parameterrefinement stage can be extended to perform auto-calibration of thesemounting, size and strength errors. Each parameter in need of perguidewire calibration is included in the partial derivative convergencemetric.

In an example, assume that there are two cylindrical magnets of lengthsD1 and D2 and field strengths S1 and S2, and that the guidewire is tworigid sections with a single hinge between the two permanent magnets.The calibration of D1, D2, S1 and S2 is performed by using an11-parameter partial derivative optimizer with the parameters: [x1 y1 z1theta1 phi1, alpha (deflection angle of the hinge), eta (rotation aboutthe first cylindrical magnet axis), D1, D2, S1 and S2].

In some embodiments, the in-body localization approaches described inthis document can be applied to endoscopic, broncho-scopic, cardio- andneuro-applications, using one or more permanent magnets incorporatedinto the medical device.

In some embodiments, the disclosed technology can be applied to physicaltherapy applications (as illustrated in FIG. 24 ). As illustratedtherein, two fixed magnets can be mounted on either side of the kneejoint to analyze joint flexure. In an example, the magnets may beincorporated into an adhesive mount. In another example, the sensor gridarray can be oriented in any manner, e.g., flag on the ground or next tojoint flexure in vertical sheet.

In some embodiments, head tracking and eye tracking applications can besupported based on the disclosed technology. An example eye-trackingsystem is illustrated in FIG. 25 . As illustrated therein, a singlepermanent magnet can be affixed to a contact lens with the grid sensorarray being incorporated into the glasses, goggles or helmet.

FIG. 26 illustrates a flowchart of an example method 2600 for estimatingthe position and orientation of an invasive medical device within apatient. The method 2600 includes, at operation 2610, receiving, from aplurality of magnetic field sensors arranged in a specific topologyseparate from the invasive medical device, a first plurality of magneticfield measurements associated with one or more permanent magnetsincorporated into the invasive medical device that is at a firstposition within the patient.

The method 2600 includes, at operation 2620, determining the location orthe orientation of the invasive medical device at the first positionbased on the first plurality of magnetic field measurements.

The method 2600 includes, at operation 2630, receiving, from theplurality of magnetic field sensors, a second plurality of magneticfield measurements associated with the one or more permanent magnets,the invasive medical device being at a second position within thepatient.

The method 2600 includes, at operation 2640, updating the location orthe orientation of the invasive medical device by determining thelocation or the orientation of the invasive medical device at the secondposition based on the second plurality of magnetic field measurements.

In some embodiments, the one or more permanent magnets consists of asingle magnet, and the operation of determining the location or theorientation of the invasive medical device at the first position, inmethod 2600, comprises generating, based on the first plurality ofmagnetic field measurements, an initial estimate for each of a pluralityof parameters of a model for the location and the orientation of theinvasive medical device, and performing, based on the first plurality ofmagnetic field measurements and the initial estimate for each of theplurality of parameters, a refinement calculation to generate a finalestimate for each of the plurality of parameters.

In some embodiments, the model for the location and the orientation ofthe invasive medical device comprises five parameters or sevenparameters.

In some embodiments, the one or more permanent magnets comprises Npermanent magnets, and N is a positive integer.

In some embodiments, the refinement calculation comprises a5×N-dimensional iterative partial derivative-based optimization.

In some embodiments, the method 2600 further includes the operation ofupdating the model based the final estimate for each of the plurality ofparameters.

In some embodiments, the invasive medical device is a catheter, acatheter guidewire, or a self-guided electrophysiology (EP) catheter.

Embodiments of the disclosed technology further provide a system forestimating a location or an orientation of an invasive medical devicethat includes one or more permanent magnets incorporated into theinvasive medical device, a plurality of magnetic field sensors arrangedin a specific topology separate from the invasive medical device, theplurality of magnetic field sensors configured to obtain a plurality ofmagnetic field measurements of the one or more permanent magnets of theinvasive medical device, and one or more processors, coupled to theplurality of magnetic field sensors, configured to receive the pluralityof magnetic field measurements, and enable a calculation of the locationor the orientation of the one or more permanent magnets based on theplurality of magnetic field measurements.

In some embodiments, the one or more processors are configured, as partof enabling the calculation of the location or the orientation of theone or more permanent magnets, to obtain, based on the plurality ofmagnetic field measurements, a plurality of differing magnetic fieldstrength values associated with at least a subset of the magnetic fieldsensors, and determine the location or the orientation of the one ormore permanent magnets using the plurality of differing magnetic fieldstrength values.

In some embodiments, the invasive surgical device comprises a catheteror a self-guided electrophysiology (EP) catheter.

In some embodiments, the one or more permanent magnets consists of asingle permanent magnet at a distal end of the invasive medical device.

In some embodiments, the one or more permanent magnets comprises a firstpermanent magnet at a distal end of the invasive medical device and asecond permanent magnet that is separated from the first permanentmagnet by a non-magnetic portion of the invasive medical device.

In some embodiments, the non-magnetic portion comprises (a) a flexibleportion, (b) two rigid portions with a hinge between the two rigidportions, or (c) a flexible circular arc with a predetermined radius.

In some embodiments, the one or more permanent magnets comprises threemagnets with a first flexible portion between a first magnet at a distalend of the invasive medical device and a second magnet, and a secondflexible portion between the second magnet and the third magnet.

In some embodiments, the invasive medical device is a catheterguidewire.

In some embodiments, each of the one or more permanent magnets comprisesa stainless steel mesh integrated with the invasive medical device.

In some embodiments, the specific topology is a uniformly-spaced planargrid.

In some embodiments, the invasive medical device is located within aperimeter of the uniformly-spaced planar grid.

In some embodiments, a spacing between two adjacent magnetic fieldsensors is substantially similar to a dimension of the one or morepermanent magnets.

In some embodiments, the specific topology is a planar grid withirregular separations between adjacent magnetic field sensors.

In some embodiments, the specific topology comprises positioning of theplurality of magnetic field sensors in three dimensions.

In some embodiments, the plurality of magnetic field sensors isconfigured as a set of stationary sensors positioned outside of apatient's body when the invasive medical device is inserted into acavity or an orifice of the patient's body.

In some embodiments, the one or more processors is further configured,as part of enabling the calculation of the location or the orientationof the one or more permanent magnets, to perform, based on the pluralityof magnetic field measurements, a geometric feature extractioncalculation to generate an initial estimate for each of a plurality ofparameters of a model for the location and the orientation of theinvasive medical device, and perform, based on the plurality of magneticfield measurements and the initial estimate for each of the plurality ofparameters, a refinement calculation to generate a convergence metricand a final estimate for each of the plurality of parameters.

In some embodiments, the one or more processors is further configured toupdate the model based the final estimate for each of the plurality ofparameters.

It is understood that the various disclosed embodiments may beimplemented individually, or collectively, in devices comprised ofvarious components, electronics hardware and/or software modules andcomponents. These devices, for example, may comprise a processor, amemory unit, an interface that are communicatively connected to eachother, and may range from desktop and/or laptop computers, to mobiledevices and the like. The processor and/or controller can performvarious disclosed operations based on execution of program code that isstored on a storage medium. The processor and/or controller can, forexample, be in communication with at least one memory and with at leastone communication unit that enables the exchange of data andinformation, directly or indirectly, through the communication link withother entities, devices and networks. The communication unit may providewired and/or wireless communication capabilities in accordance with oneor more communication protocols, and therefore it may comprise theproper transmitter/receiver antennas, circuitry and ports, as well asthe encoding/decoding capabilities that may be necessary for propertransmission and/or reception of data and other information.

Implementations of the subject matter and the functional operationsdescribed in this patent document can be implemented in various systems,digital electronic circuitry, or in computer software, firmware, orhardware, including the structures disclosed in this specification andtheir structural equivalents, or in combinations of one or more of them.Implementations of the subject matter described in this specificationcan be implemented as one or more computer program products, i.e., oneor more modules of computer program instructions encoded on a tangibleand non-transitory computer readable medium for execution by, or tocontrol the operation of, data processing apparatus. The computerreadable medium can be a machine-readable storage device, amachine-readable storage substrate, a memory device, a composition ofmatter effecting a machine-readable propagated signal, or a combinationof one or more of them. The term “data processing unit” or “dataprocessing apparatus” encompasses all apparatus, devices, and machinesfor processing data, including by way of example a programmableprocessor, a computer, or multiple processors or computers. Theapparatus can include, in addition to hardware, code that creates anexecution environment for the computer program in question, e.g., codethat constitutes processor firmware, a protocol stack, a databasemanagement system, an operating system, or a combination of one or moreof them.

A computer program (also known as a program, software, softwareapplication, script, or code) can be written in any form of programminglanguage, including compiled or interpreted languages, and it can bedeployed in any form, including as a stand-alone program or as a module,component, subroutine, or other unit suitable for use in a computingenvironment. A computer program does not necessarily correspond to afile in a file system. A program can be stored in a portion of a filethat holds other programs or data (e.g., one or more scripts stored in amarkup language document), in a single file dedicated to the program inquestion, or in multiple coordinated files (e.g., files that store oneor more modules, sub programs, or portions of code). A computer programcan be deployed to be executed on one computer or on multiple computersthat are located at one site or distributed across multiple sites andinterconnected by a communication network.

The processes and logic flows described in this specification can beperformed by one or more programmable processors executing one or morecomputer programs to perform functions by operating on input data andgenerating output. The processes and logic flows can also be performedby, and apparatus can also be implemented as, special purpose logiccircuitry, e.g., an FPGA (field programmable gate array) or an ASIC(application specific integrated circuit).

Processors suitable for the execution of a computer program include, byway of example, both general and special purpose microprocessors, andany one or more processors of any kind of digital computer. Generally, aprocessor will receive instructions and data from a read only memory ora random access memory or both. The essential elements of a computer area processor for performing instructions and one or more memory devicesfor storing instructions and data. Generally, a computer will alsoinclude, or be operatively coupled to receive data from or transfer datato, or both, one or more mass storage devices for storing data, e.g.,magnetic, magneto optical disks, or optical disks. However, a computerneed not have such devices. Computer readable media suitable for storingcomputer program instructions and data include all forms of nonvolatilememory, media and memory devices, including by way of examplesemiconductor memory devices, e.g., EPROM, EEPROM, and flash memorydevices. The processor and the memory can be supplemented by, orincorporated in, special purpose logic circuitry.

While this patent document contains many specifics, these should not beconstrued as limitations on the scope of any invention or of what may beclaimed, but rather as descriptions of features that may be specific toparticular embodiments of particular inventions. Certain features thatare described in this patent document in the context of separateembodiments can also be implemented in combination in a singleembodiment. Conversely, various features that are described in thecontext of a single embodiment can also be implemented in multipleembodiments separately or in any suitable subcombination. Moreover,although features may be described above as acting in certaincombinations and even initially claimed as such, one or more featuresfrom a claimed combination can in some cases be excised from thecombination, and the claimed combination may be directed to asubcombination or variation of a subcombination.

Similarly, while operations are depicted in the drawings in a particularorder, this should not be understood as requiring that such operationsbe performed in the particular order shown or in sequential order, orthat all illustrated operations be performed, to achieve desirableresults. Moreover, the separation of various system components in theembodiments described in this patent document should not be understoodas requiring such separation in all embodiments.

Only a few implementations and examples are described and otherimplementations, enhancements and variations can be made based on whatis described and illustrated in this patent document.

What is claimed is:
 1. A method for obtaining a location or anorientation of an invasive medical device inside a patient, comprising:receiving, from a plurality of magnetic field sensors arranged in aspecific topology separate from the invasive medical device, a firstplurality of magnetic field measurements associated with one or morepermanent magnets incorporated into the invasive medical device that isat a first position within the patient, wherein the one or morepermanent magnets is at a height above the specific topology that isless than or equal to twice a width of the specific topology;determining the location or the orientation of the invasive medicaldevice at the first position based on the first plurality of magneticfield measurements, wherein the determining the location or theorientation comprises: performing, based on the first plurality ofmagnetic field measurements, a geometric feature extraction calculationto generate an initial estimate for each of a plurality of parameters ofa model for the location and the orientation of the invasive medicaldevice, and performing, based on the first plurality of magnetic fieldmeasurements and the initial estimate for each of the plurality ofparameters, a refinement calculation to generate a convergence metricand a final estimate for each of the plurality of parameters, whereinthe refinement calculation comprises an N-dimensional partial derivativedriven convergence method, wherein a predicted value of at least one ofthe first plurality of magnetic field measurements converges to acorresponding one of the first plurality of magnetic field measurements,and wherein N is a positive integer; receiving, from the plurality ofmagnetic field sensors, a second plurality of magnetic fieldmeasurements associated with the one or more permanent magnets, whereinthe invasive medical device is at a second position within the patient;and updating the location or the orientation of the invasive medicaldevice by determining the location or the orientation of the invasivemedical device at the second position based on the second plurality ofmagnetic field measurements.
 2. The method of claim 1, wherein the modelfor the location and the orientation of the invasive medical devicecomprises five parameters or seven parameters.
 3. The method of claim 1,wherein the one or more permanent magnets comprises N permanent magnets.4. The method of claim 3, wherein the refinement calculation comprises a5×N-dimensional iterative partial derivative-based optimization.
 5. Themethod of claim 1, further comprising: updating the model based thefinal estimate for each of the plurality of parameters.
 6. The method ofclaim 1, wherein the invasive medical device is a catheter or aself-guided electrophysiology (EP) catheter.
 7. The method of claim 6,wherein the one or more permanent magnets consists of a single permanentmagnet at a distal end of the invasive medical device.
 8. The method ofclaim 6, wherein the one or more permanent magnets comprises a firstpermanent magnet at a distal end of the invasive medical device and asecond permanent magnet that is separated from the first permanentmagnet by a non-magnetic portion of the invasive medical device.
 9. Themethod of claim 8, wherein the non-magnetic portion comprises (a) aflexible portion, (b) two rigid portions with a hinge between the tworigid portions, or (c) a flexible circular arc with a predeterminedradius.
 10. The method of claim 6, wherein the one or more permanentmagnets comprises three magnets with a first flexible portion between afirst magnet at a distal end of the invasive medical device and a secondmagnet, and a second flexible portion between the second magnet and athird magnet.
 11. The method of claim 1, wherein the invasive medicaldevice is a catheter guidewire.
 12. The method of claim 11, wherein eachof the one or more permanent magnets comprises a stainless steel meshintegrated with the invasive medical device.
 13. The method of claim 11,wherein the one or more permanent magnets comprises at least onecylindrical magnet surrounding one or more central lumens of thecatheter guidewire.
 14. The method of claim 1, wherein the specifictopology is a uniformly-spaced planar grid.
 15. The method of claim 14,wherein the invasive medical device is located within a perimeter of theuniformly-spaced planar grid.
 16. The method of claim 14, wherein aspacing between two adjacent magnetic field sensors is similar to adimension of the one or more permanent magnets.
 17. The method of claim1, wherein the specific topology is a planar grid with irregularseparations between adjacent magnetic field sensors.
 18. The method ofclaim 1, wherein the specific topology comprises positioning of theplurality of magnetic field sensors in three dimensions.
 19. The methodof claim 1, wherein the plurality of magnetic field sensors isconfigured as a set of stationary sensors positioned outside of thepatient.
 20. A non-transitory computer-readable storage medium havinginstructions stored thereupon that are executable by a processor forobtaining a location or an orientation of an invasive medical deviceinside a patient, comprising: instructions for receiving, from aplurality of magnetic field sensors arranged in a specific topologyseparate from the invasive medical device, a first plurality of magneticfield measurements associated with one or more permanent magnetsincorporated into the invasive medical device that is at a firstposition within the patient, wherein the one or more permanent magnetsis at a height above the specific topology that is less than or equal totwice a width of the specific topology; instructions for determining thelocation or the orientation of the invasive medical device at the firstposition based on the first plurality of magnetic field measurements,wherein the instructions for determining the location or the orientationcomprises: instructions for performing, based on the first plurality ofmagnetic field measurements, a geometric feature extraction calculationto generate an initial estimate for each of a plurality of parameters ofa model for the location and the orientation of the invasive medicaldevice, and instructions for performing, based on the first plurality ofmagnetic field measurements and the initial estimate for each of theplurality of parameters, a refinement calculation to generate aconvergence metric and a final estimate for each of the plurality ofparameters, wherein the refinement calculation comprises anN-dimensional partial derivative driven convergence method, wherein apredicted value of at least one of the first plurality of magnetic fieldmeasurements converges to a corresponding one of the first plurality ofmagnetic field measurements, and wherein N is a positive integer;instructions for receiving, from the plurality of magnetic fieldsensors, a second plurality of magnetic field measurements associatedwith the one or more permanent magnets, wherein the invasive medicaldevice is at a second position within the patient; and instructions forupdating the location or the orientation of the invasive medical deviceby determining the location or the orientation of the invasive medicaldevice at the second position based on the second plurality of magneticfield measurements.